tbuckley/cabot-search huggingface dataset:
POS1288 TREAT TO TARGET MANAGEMENT OF FIBROMYALGIA: EVIDENCE-BASED CONSENSUS ON CLINICAL PRACTICE GUIDELINES
Authors: Y. El Miedany, M. H. Abu-Zaid, M. Elgaafary, N. Ali, D. Mohasseb, A. Zohiery, W. Hassan, M. A. Mortada, M. Eissa, S. A. A. Tabra, N. Fouad, N. Gaballah, F. El Noby, S. Saber, S. Moussa
Journal: Annals of the Rheumatic Diseases (2022)

Background Because of the subjective character of symptoms, absence of a diagnostic test, modest response to treatments, and at times, patient reports of important functional disability, fibromyalgia remains a challenge for the treating health care professionals in the standard clinical practice. Objectives To develop an up to date consensus, evidence-based clinical practice guidelines for treat to target management of fibromyalgia. Methods 15 key clinical questions were identified by a scientific committee according to the Patient/ Population, Intervention, Comparison, and Outcomes (PICO) approach. A literature review team performed a systematic review to summarize evidence advocating the benefits and harms of available pharmacologic and nonpharmacologic therapies for fibromyalgia. Subsequently, recommendations were formulated. The level of evidence was determined for each section using the Oxford Centre for Evidence-based Medicine (CEBM) system. A 3-round Delphi process was conducted with 16 experts. All rounds were conducted online. A consensus was achieved on the direction and the strength of the recommendations. Results An online questionnaire were sent to expert panel who participated in the three rounds (response rate 100%). At the end of round 3, a total of fifteen recommendation items, categorized into 10 sections to address the main fibromyalgia categories, were obtained. Agreement with the recommendations (rank 7-9) ranged from 85-100%. Consensus was reached (i.e.≥80%of respondents strongly agreed or agreed) on the wording of all the 15 clinical standards identified by the scientific committee. Algorithm for the management of fibromyalgia have been suggested. Conclusion These recommendations provide an updated consensus on both the non-pharmacological as well as the pharmacological treatment of fibromyalgia. The provide strategies to reach optimal treat to target outcomes in common clinical scenarios, based on a combination of evidence and expert opinion. Best treatment decisions should be tailored to each individual patient situation. Disclosure of Interests None declared
AB0595 INFANTILE TAKAYASU: CLINICAL FEATURES AND LONG TERM OUTCOME
Authors: A. Miller Barmak, F. Sztajnbok, S. Özen, Z. Balik, A. Borzutzky, L. Fogel, O. Goldzweig, Y. Butbul
Journal: Annals of the Rheumatic Diseases (2022)

Background Takayasu arteritis (TA) is a large vessel vasculitis rarely reported in children, and its incidence is extremely low in infants. Most articles on pediatric TA have not focused on infants. We present the largest case series of infantile TA aiming to characterize demographic and clinical data and compare it with existing data on older children. Objectives Characterize demographic and clinical data reagrding TA and compare it with existing data on older children Methods We conducted an international multi-center retrospective cohort study. Epidemiological and clinical data were collected from patient charts by doctors from six centers. Results Twelve patients (50% female) meeting the ACR criteria of TA were included. Median age of symptom onset was 11 months, with a diagnostic delay of 4 months and median time of follow up of 7.5 years. The most common symptoms at presentation were hypertension, BP difference between upper and lower limbs, and fever. The arteries most commonly involved at diagnosis were the abdominal aorta, renal artery, and superior mesenteric artery. Different medications used included steroids, conventional and biological DMARDS, and other immunosuppressive therapies. Half of the patients received biologic agents of which infliximab had the highest complete remission rate (40%). Other medications resulting in complete remission were cyclophosphamide (40%) and methothrexate (38%). Invasive procedures were needed in 58% of patients. The most common complications were cardiac (50%), strokes (42%) and serious infections (33%). None of the patients died. Conclusion This study presents the largest series of infantile TA. Compared to reported series on older children, infants with TA were more likely to receive biologic agents, develop complications and require invasive interventions. Disclosure of Interests None declared
AB1247 ASSESSMENT OF ARTICULAR AND EXTRA-ARTICULAR DAMAGE IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS
Authors: A. Fazaa, N. Ben Salem, S. Miladi, H. Boussaa, L. Souabni, K. Ouenniche, S. Chekili, S. Kassab, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2022)

Background Juvenile idiopathic arthritis (JIA) affects patients’ well-being and can lead to disability and long-term damage. Evaluating damage in patients can be beneficial to make therapeutic decisions and take rehabilitation measures. Objectives To assess articular and extra articular damage in patients with JIA by the use of the Juvenile Arthritis Damage Index (JADI) 1 and to identify variables that correlate with disease damage. Methods We conducted a cross-sectional study among patients with JIA who met the ILAR classification criteria and had a disease duration more than 12 months. Early clinical data was obtained from medical files. It included sociodemographic features, biological and radiological parameters, subtype of JIA, disease duration and ongoing treatments. Damage was assessed in the last clinical visit using articular and extra-articular damage index 1 (JADI-A and JADI-E). Results Thirty-two patients were enrolled in this study with a mean age of 23.8 ±11.6 years. Sex ratio was 0.6 (12 males and 20 females). The mean age of disease onset was 8.3 years [3-15], and the mean disease duration was 183.7 months [12-624]. At the last clinical examination, 71.9% of patients had joint damage with a mean JADI-A score of 5.09 ±5.4 and 40.6% of patients had extra-articular damage with a mean JADI-E score of 0.75±1.2. The most affected joints were: the elbows (43.8%), the hips (37.5%) and the wrists (25%). Extra articular damage was mainly: a growth failure (25%), osteoporosis (18.8%) and ocular damage (12.5%). Patients with polyarticular arthritis without rheumatoid factor had the highest JADI-A score with a mean of 7.83 while patients with systemic arthritis had the highest JADI-E score with a mean of 3. Mean JADI-A score was significantly different between patients who received corticosteroids and those who did not receive them (8.5 Versus 3.4, p=0.004). Damage scores correlated with disease duration (p&lt;0.001 for JADI-A score and p=0.034 for JADI-E score). Damage scores were not significantly different between different classes of treatment (conventional dmards and biologic dmards). Conclusion Articular damage is frequent in patients with JIA. It is higher for patients on corticosteroids. Articular and extra articular damage correlate with disease duration, but they were not significantly different between classes of treatment. References [1]Viola and al: ‘Development and Validation of a Clinical Index for Assessment of Long-Term Damage in Juvenile Idiopathic Arthritis’. Disclosure of Interests None declared
AB0065 ASSOCIATION OF SERUM LEVELS OF NESFATIN-1 WITH RHEUMATOID ARTHRITIS ACTIVITY AND ANXIETY-DEPRESSIVE DISORDERS
Authors: J. Polyakova, L. Seewordova, E. Papichev, Y. Akhverdyan, T. Kvlividze, В. Zavodovsky
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is primarily associated with pain levels and limited function. Depressive disturbances and anxiety levels are not usually assessed, the focus is on the physical aspects of the disease. At the same time, patients with high disease activity often experience a decrease in body weight and lack of appetite, which is referred to as rheumatoid cachexia. Nesfatin-1 (NF-1), discovered as an anorexigenic protein. The participation of NF-1 in the regulation of eating behavior and reactions to emotional stress together with oxytocin, melatonin, serotonin, and histamine receptors has been proven. Elevated levels of NF-1 are detected in more severe forms of depression, correlating with the level of inflammation markers - C-reactive protein and interleukin-6. Recent work confirms an increase in NF-1 levels in RA, although its role in inflammation has not yet been clearly defined. Objectives To determine the correlation of the level of NF-1 in the blood serum of patients with RA with the level of anxiety and depression. Methods 110 patients with RA were examined. NF-1 level concentration was determined by indirect enzyme-linked immunosorbent assay (RaiBiotech, cat no. EIA-NESF). The PHQ-9 scale was used to assess the severity of depressive symptoms, and the GAD-7 scale was used to assess the severity of anxiety symptoms. Results Mood disorders of varying severity were detected in 48% of patients with RA. The highest levels of NF-1 were found in patients with high RA activity according to DAS-28 and disease duration of more than 10 years. The level of anxiety was more correlated with the severity of the disease activity (r = 0.351; p&lt;0.01), and the level of depression was more correlated with the duration of the disease (r = 0.273; p&lt;0.01). Conclusion In our study depression and high levels of anxiety were found in 48% of patients with RA, which is consistent with well-known data (the prevalence of mood disorders in RA ranges from 30 to 75%). The severity of depression and anxiety correlates with the level of NF-1, the frequency of occurrence depends on the activity and duration of the disease. References [1]Aleksandrov A., Aleksandrova N. Peculiarities of interaction of chronic inflammation and depression in Rheumatoid arthritis. Annals of the Rheumatic Diseases. 2021. Т. 80. № S1. С. 1110. [2]Hofmann T, Weibert E, Ahnis A, Obbarius A, Elbelt U, Rose M, Klapp BF, Stengel A. Alterations of circulating NUCB2/nesfatin-1 during short term therapeutic improvement of anxiety in obese inpatients. Psychoneuroendocrinology. 2017 May;79:107-115. doi: 10.1016/j.psyneuen.2017.02.021 [3]Kvlividze T, Zavodovsky B, Akhverdyan Y, Polyakova Y, Sivordova L, Yakovlev A. Serum nesfatin-1 as a marker of systemic inflammation in rheumatoid arthritis. Klin Lab Diagn 2019;64:53-6. doi: 10.18821/0869-2084-2019-64-1-53-56 Disclosure of Interests None declared
POS1190 IMPACT OF COVID-19 PANDEMIC ON PATIENTS WITH RHEUMATIC AND MUSCULOSKELETAL DISEASES: DISRUPTIONS IN CARE AND SELF-REPORTED OUTCOMES
Authors: A. M. Fouad, S. F. Elotla, E. Nourhan Elameen, A. E. Mohamed
Journal: Annals of the Rheumatic Diseases (2022)

Background The COVID-19 pandemic represents a challenge to the care of patients with rheumatic and musculoskeletal diseases (RMDs). Objectives This study aimed to evaluate the impact of the pandemic on the care of RMD patients, their health and wellbeing. Methods This cross-sectional study involved 120 RMDs patients at the rheumatology department at Suez Canal University Hospital in Ismailia, Egypt. Patients were interviewed for sociodemographic and disease-related history. Further assessments were performed using Kessler 6-items (1), Fear of COVID-19 scale (2), and COVID-19–Impact on Quality-of-Life scale (3). Results Patients with rheumatoid arthritis and systemic lupus erythematosus made up most of our sample (72.5%, 19.2% respectively). About 50% of patients were experiencing limitation in the access to rheumatologic care, and a similar percentage had changed or discontinued their medications. DMARDs shortage and concerns about the increased risk of COVID-19 infection because of immunosuppressive drugs were the most frequently reported reasons for non-adherence to medication. The percentage of patients with uncontrolled disease had significantly increased from 8.3% prior to the COVID-19 pandemic to 20% during the pandemic. Patients perceived their overall quality of life as average (4.93 on a rating scale from 0 to 10). The Fear of COVID-19 score ranged from 7 to 35 with a mean of 26 (±7.6), while the COV19–Impact on Quality of Life score ranged from 6 to 30 points with a mean of 22.6 (±6.7). About 60% of patients reported a high level of psychological distress. Conclusion The pandemic negatively influenced the mental health, quality of life, adherence to medications, access to rheumatology care, and disease control of RMDs patients. References [1]Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological medicine. 2002 Aug;32(6):959-76. [2]Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addict 2020;1-9. doi:10.1007/s11469-020-00270-8. [3]Repišti S, Jovanović N, Kuzman MR, Medved S, Jerotić S, Ribić E, Majstorović T, Simoska SM, Novotni L, Milutinović M, Stoilkovska BB. How to measure the impact of the COVID-19 pandemic on quality of life: COV19-QoL–the development, reliability and validity of a new scale. Global Psychiatry 2020, 3(2), 2020, 201-10. doi: 10.2478/gp-2020-0016. Disclosure of Interests None declared
How Abortion Bans Could Affect Care for Miscarriage and Infertility
Authors: Rita Rubin
Journal: JAMA (2022)

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AB0309 ASSOCIATION BETWEEN RHEUMATIC DISEASE COMORBIDITY INDEX AND PULMONARY INVOLVEMENT IN RHEUMATOID ARTHRITIS
Authors: E. Hannech, A. Ben Tekaya, O. Saidane, R. Leila, S. Bouden, R. Tekaya, I. Mahmoud, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2022)

Background Pulmonary involvement is one of the primary contributors of morbi-mortality among patients followed for Rheumatoid Arthritis (RA) [1]. Comorbidities are also independent factors of poor outcomes on those debilitated population. Objectives We aimed to assess association between comorbidity and pulmonary involvement in rheumatoid arthritis Methods We conducted a retrospective study in our rheumatology department including patients with established RA according to the ACR/EULAR 2010 criteria. Rheumatic Disease Comorbidity Index (RDCI) was calculated for each patient. Clinical characteristics, radiological findings, and respiratory function tests (PFTs) for pulmonary involvement were collected. Results There were 255 patients: 212 female (83.1%) and 43 male (16.9%). The mean age was 58.92 ± 10.72 years [25-85]. The mean RDCI was 1.14 ± 1.25 [0-6]. Pulmonary involvement was noted in 115 patients (45.3%). It was asymptomatic in 50.6% of cases. Reported clinical symptoms were dyspnea (36.1%), chronic cough (8.4%), and dyspnea with chronic cough (4.8%). PFT showed a restrictive syndrome in 34.9% of cases, an obstructive syndrome in 4.8%, a mixed syndrome 3.6% and was normal in 56.6% of patients. Non-specific interstitial pneumonia was noted in 26.6% of patients, followed by nodular lung disease in 11.4 %, usual interstitial pneumonia in 11.4%, BOOP in 6.3%, and then pleural nodules in 6.3%. An association was noted between RDCI and pulmonary involvement (presence: 1.7 ± 1.3 vs absence: 0.6 ± 0.8, p&lt;10 -3 ). Conclusion In conclusion, there was an elevated comorbidity index in patients with pulmonary involvement. Comorbidities may be a predictive factor of extra-articular manifestations. The early management may improve outcomes in RA patients. References [1]Hyldgaard C, Hilberg O, Pedersen AB, Ulrichsen SP, Løkke A, Bendstrup E, et al.A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease: comorbidity and mortality. Ann Rheum Dis. 2017;76(10):1700–1706. Disclosure of Interests None declared
POS0552 RELATIONSHIP BETWEEN PAINLESS MYOCARDIAL ISCHEMIA WITH LEVEL WILLEBRAND FACTOR AND INFLAMMATORY MARKERS IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: O. Galiutina, M. Stanislavchuk, O. Bychak, Y. Seheda
Journal: Annals of the Rheumatic Diseases (2022)

Background In a patient with rheumatoid arthritis (RA) manifestations of coronary heart disease occur gradually, at the same time “painless” myocardial ischemia is detected in 50 - 70% of cases according to the literature. According to modern ideas, the formation of endothelial dysfunction, development of early atherosclerosis and vascular thrombosis are closely associated with the increase level of von Willebrand factor (VWF) and inflammatory markers. Objectives The aim of this study was to investigate the frequency and duration of painless myocardial ischemia and its association with VWF levels and inflammatory markers in patients with RA. Methods 63 patients with RA (44 women) aged 27 - 65 years (mean age - 46.8 ± 9.8 years) and 69 ages and sex-matched controls were examined. Serum levels of VWF, CRP and TNF-α were determined by enzyme-linked immunosorbent assays. Daily (Holter) ECG monitoring was performed by Holter ECG monitoring systems “DiaCard”, registrar: model 02100, software version 1.0.40, developed by JSC “Solveig” (Ukraine). Results It was found, that the part of patients with painless myocardial ischemia among patients with RA was significantly higher (58.7%) than in the control group (13%). At the same time, in patients with RA the duration of painless myocardial ischemia was in averaged 10.9 ± 8.1 minutes per day. It was significantly more than in the control group 2.88±1.25 minutes per day (p &lt;0,05). It was found, that in patients with RA there was an increased levels of VWF (162.2 ± 9.3% vs. 86.2 ± 2.7% in control). It was found, that the duration of painless myocardial ischemia had close correlations with VWF (r = 0.28), CRP (r = 0.41) and TNF-α (r = 0.40). Conclusion The severity the duration of painless myocardial ischemia in RA patients is associated with elevated levels of VWF, CRP, and TNF-α, indicating the possible involvement of VWF and inflammatory markers in cardiovascular disease in RA patients. References [1]Hannawi, S., Hannawi, H., Al Salmi I. (2020). Cardiovascular disease and subclinical atherosclerosis in rheumatoid arthritis. Hypertension Research, 43, 982–984 Disclosure of Interests None declared.
AB1373 RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY (REMS) AS AN ALTERNATIVE APPROACH TO BIOELECTRICAL IMPEDANCE ANALYSIS (BIA) FOR THE ASSESSMENT OF BODY COMPOSITION
Authors: P. Pisani, A. Natale, F. A. Lombardi, F. Conversano, E. Casciaro, M. Muratore, S. Casciaro
Journal: Annals of the Rheumatic Diseases (2022)

Background The evaluation of human body composition is crucial for body weight management, especially in pathological conditions. Patients whose body weight greatly exceeds or remain below the reference range, need regular monitoring in order to personalise the nutritional treatment plan. To this end, bioelectrical impedance analysis (BIA) is a widely accepted tool, along with ultrasound techniques. Among emerging ultrasound-based technologies, Radiofrequency Echographic Multi Spectrometry (REMS) is a powerful approach that can be effectively used for body composition analysis. Objectives The present study aims to assess the accuracy of REMS in comparison to BIA for body composition assessment. Methods The cohort included 141 males and females aged between 60 and 80 years. All subjects underwent body mass measurement by REMS and BIA and both body fat percentage (BFP) and basal metabolic rate (BMR) parameters were assessed. Results The estimation of BFP measured with BIA resulted in 40.4% (interquartile range [IQR]: 35.5% to 45.2%), which value did not differ from 41.1% (IQR: 36.5% to 47.1%) obtained with REMS (p=0.6). The BMR determined by BIA was 1329.0 kcal/day (IQR: 1270.5 to 1423.5 kcal/day), which was in a similar range as the value of 1323.5 kcal/day (IQR: 1266.0 to 1420.0 kcal/day) assessed by REMS (p=0.7). Conclusion The present study demonstrated the excellent ability of REMS to accurately determine the body composition, resulting as an alternative approach to conventional BIA. Disclosure of Interests Paola Pisani: None declared, Alessandra Natale: None declared, Fiorella Anna Lombardi: None declared, Francesco Conversano Shareholder of: Francesco Conversano owns stocks of Echolight Spa, Ernesto Casciaro Shareholder of: Ernesto Casciaro owns stocks of Echolight Spa, Maurizio Muratore: None declared, Sergio Casciaro Shareholder of: Sergio Casciaro owns stocks of Echolight Spa